UPMC Physician Resources

Children’s Names New Chief of Pediatric Endocrinology

PITTSBURGH, March 18, 2014Children’s Hospital of Pittsburgh of UPMC has named Radhika Muzumdar, MD, chief of the Division of Pediatric Endocrinology, Diabetes and Metabolism. Dr. Muzumdar also has an appointment within the University of Pittsburgh School of Medicine as associate professor of Pediatrics and Cell Biology. She comes to Pittsburgh from Albert Einstein College of Medicine and The Children’s Hospital at Montefiore in Bronx, N.Y.

Dr. Muzumdar brings expertise in basic research in endocrinology to Children’s, and as the principle investigator for seminal research on the role of insulin-like growth factors and novel peptides that regulate glucose homeostasis during aging, she is supported by National Institutes of Health (NIH) R-01 funding.

Dr. Muzumdar, a member of the Society for Pediatric Research, has been elected to various leadership roles in national and international subspecialty societies. She also has been recognized for her teaching abilities and mentoring in clinical medicine and biomedical research, and will lead Children’s NIH T32 fellowship training grant.

Welcoming New Faculty, Shyam Kodati, MD

Shyam Kodati, MD, FRCS, FRCOphth, has joined the UPMC Eye Center as a clinical assistant professor of ophthalmology. He is a graduate of Osmania Medical College in India. Dr. Kodati completed his residency in ophthalmology at the Royal College of Ophthalmology in London, and a fellowship in ocular oncology at the University of Toronto. He joins UPMC after working as an ophthalmic surgeon in the United Kingdom.

Dr. Kodati’s research interests include:

  • Retinal Imaging
  • Medical retinal conditions including ARMD and diabetic retinopathy

 

 

Older Age at Onset of Type 1 Diabetes Associated with Lower Brain Connectivity Later in Life

SAN FRANCISCO, March 14, 2014 – Children and adolescents older than age 8 at the onset of type 1 diabetes had weaker brain connectivity when tested later in life relative to those who had earlier ages of diagnosis, University of Pittsburgh Schools of the Health Sciences researchers discovered.

The findings, presented today at the American Psychosomatic Society’s annual meeting, were made by analyzing the brain scans of 44 middle-age adults diagnosed with type 1 diabetes as children.

“Adolescence is a time when the brain matures and makes connections in networks responsible for different functions,” said John Ryan, Ph.D., assistant professor of psychiatry at Pitt. “Further study is needed to determine if and how the onset of type 1 diabetes shortly before or during puberty affects brain function and how better control of the disease at that important time could yield changes in brain function later in life.”

Half the study participants had onset of type 1 diabetes before age 8 and were matched with participants of the same sex and age who were diagnosed after age 8, but before age 17. All were enrolled in the Pittsburgh Epidemiology of Diabetes Complications Study, an ongoing investigation led by Pitt’s Graduate School of Public Health to document long-term complications of type 1 diabetes among patients at Children’s Hospital of Pittsburgh of UPMC between 1950 and 1980.

Type 1 diabetes is usually diagnosed in children and young adults and happens when the body does not produce insulin, a hormone that is needed to convert sugar into energy, and can lead to nerve and organ damage. With insulin therapy and other treatments, the condition can be controlled.

Dr. Ryan noted that his findings were a “snapshot” of scans and tests from one time point, and repeated scans and tests over the next five to 10 years will be critical to determine if the weaker brain connectivity might be linked to cognitive function, and if any predictive markers could be found in the brain scans that might warn of future cognitive impairment.

“The fact that adults with type 1 diabetes are now living longer than ever is certainly a success of treatment advancements, but it also presents an urgent public health problem,” said Caterina Rosano, M.D., M.P.H., senior author of this work and associate professor of epidemiology at Pitt Public Health. “A striking feature of these patients is that they develop brain abnormalities similar to those observed in much older adults without diabetes. It is very possible that older age may amplify the progression of brain abnormalities and possibly lead to a faster cognitive decline than what would be observed because of age alone. We need to rapidly identify and prevent the characteristics of this accelerated brain aging in type 1 diabetics if we want to ensure the highest quality of life for these patients.”

Additional researchers on this project include Howard J. Aizenstein, M.D., Ph.D., Department of Psychiatry, Pitt School of Medicine; and Trevor J. Orchard, M.B.B.Ch., M.Med.Sci., F.A.H.A., F.A.C.E., Department of Epidemiology, Pitt Public Health.

Falls Among Pennsylvania Elderly Reduced by State Program

PITTSBURGH, March 13, 2014 – A low-cost program reduced falls in the elderly by 17 percent statewide, illustrating the value and effectiveness of using existing aging services, such as senior centers, in preventing falls, a University of Pittsburgh Graduate School of Public Health study determined.

Pitt Public Health researchers followed nearly 2,000 older Pennsylvanians between 2010 and 2011 to determine the effectiveness of the state’s Healthy Steps for Older Adults, a voluntary fall-prevention program. Results of the study, funded by the U.S. Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH), will be published in the May issue of the American Journal of Public Health and are now available online.

“There is a high prevalence of falls among people 65 and older that increases with age, as does the inability to get up after a fall,” said lead author Steven Albert, Ph.D., chairman of the Department of Behavioral and Community Health Sciences at Pitt Public Health. “A challenge for public health officials is to decrease the risk of falls without encouraging reduced physical activity. Our research shows that the Healthy Steps for Older Adults program is a successful tool to help reduce falls.”

According to the CDC, one in three adults aged 65 and older falls each year and, of those who fall, 20 to 30 percent suffer moderate to severe injuries that make it hard for them to live independently, and increase their risk of early death.

By 2020, the CDC estimates, the annual direct and indirect cost of fall injuries will reach $67.7 billion.

Healthy Steps for Older Adults, run by the Pennsylvania Department of Aging, offers risk screening for falls and educational information regarding fall prevention, for adults 50 years and older. Participants who are identified as high risk for falls are referred to primary care providers and encouraged to complete home safety assessments, which identify modification — including banisters and grab bars — to reduce hazards in their homes that might put them at greater risk for falls.

The program is designed to be administered by volunteers at senior centers to keep costs low. Between 2010 and 2011, the state reimbursed the centers $70 per person for delivering the program, allocating $1.2 million to the program as a whole.

Dr. Albert and his co-authors recruited 814 older adults at senior centers statewide to complete the program, and compared them to 1,019 counterparts who did not. The average age of study participants was 75.4 years.

Of those who completed the program and were informed they were at high risk for falls, 21.5 percent followed up with physicians. More than three-quarters of program participants at high risk conducted home safety assessments, and a third went on to reduce home hazards.

“Though further analyses will be necessary to understand specifically how these actions translated into a 17 percent reduction in falls, it appears that referrals for physician care and home safety assessments, along with informing older adults of their high-risk status and heightening their sensitivity to situations involving a risk of falling, may lead to reductions in falls,” said Dr. Albert.

Additional researchers on this study are Anne B. Newman, M.D., M.P.H., Robert Boudreau, Ph.D., and Tanushree Prasad, M.A., all of the Pitt Public Health Department of Epidemiology; Jennifer King, B.A., of the Pitt Public Health Department of Community and Behavioral Health; and Chyongchiou J. Lin, Ph.D., of the Pitt School of Medicine.

This study was supported by CDC cooperative agreement DP002657 and grant U48 DP001918, and NIH grant P30 AG024827.

Dr. Fu Receives Career Award from National Orthopaedic Society; International Honors To Follow

PITTSBURGH, March 12, 2014 – Freddie Fu, M.D., tonight received the Elizabeth Winston Lanier Award for his career contribution to anterior cruciate ligament (ACL) reconstruction and advances in patient care, an accolade considered the Nobel Prize of orthopaedic research and bestowed by the Kappa Delta Sorority along with the Orthopaedic Research and Education Foundation. It was presented to Dr. Fu in New Orleans at the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), a conference of 10,000 professionals.

Dr. Fu, the David Silver Professor and Chairman of the University of Pittsburgh Department of Orthopaedic Surgery and founder of the UPMC Center for Sports Medicine, also will receive honors in Europe and Asia over the next four months:

  • In Amsterdam in May, the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) is scheduled to present its highest honor to Dr. Fu by making him a Lifetime Honorary Member and a member of its Hall of Fame — the first from Pennsylvania, the second from the United States, and only the fourth inductee to date.
  • In Hiroshima, Japan, in July, the Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine (JOSKAS) will make Dr. Fu only the fourth surgeon — and second from the Western Hemisphere — recognized with the Masaki Watanabe Award for international achievement in arthroscopic surgery.

“These honors are truly gratifying, but they represent the research, diligence and clinical excellence of so many people rather than one person,” said Dr. Fu, whom the AAOS also honored three years ago with its 2011 Diversity Award. “It is a testament to the orthopaedic and sports-medicine programs at Pitt and UPMC, where we have spent the past three and a half decades creating an environment that is conducive to educating students and improving and studying treatment, surgery, imaging, rehabilitation and outcomes for our patients.”

In the past quarter-century, roughly 600 fellows from around the world have come to Pittsburgh to train. In addition to caring for patients, overseeing orthopaedics and sports medicine, and serving as the head team physician for Pitt athletics, Dr. Fu also remains committed to research and education. He is among the first eight faculty members of the School of Medicine to receive Pitt’s designation as a Distinguished Service Professor.

The Lanier Award, one of two Kappa Delta research awards established in 1947, honored Dr. Fu for his work surrounding ACL repair — an injury that can result in acute instability and long-term clinical problems, such as osteoarthritis. He supervised research that redefined long-standing assumptions about the ligament and developed new approaches to reconstructing it by replicating the knee’s native anatomy to restore long-term knee function, not to mention the patient’s quality of life.

Dr. Fu is scheduled to make a presentation relating to his award-winning work on Sunday at the Orthopaedic Research Society annual meeting held in conjunction with the AAOS.

On May 16 in The Netherlands, ESSKA will honor Dr. Fu at its General Assembly, which is held every other year. Its eight-member board of directors met in Glasgow, Scotland, last month and unanimously voted to award him with Lifetime Honorary Membership at its upcoming conference. ESSKA, with 4,000 members, is the largest orthopaedic society in Europe.

“Dr. Fu is one of the most outstanding scientists and surgeons in the world in orthopaedic sports medicine,” said Joao Espregueira Mendes, M.D., ESSKA president and professor and chairman of the Minho University Orthopaedic Department, Porto, Portugal. “He is without doubt the person most influential in advancing the knowledge of ACL surgery in the past 10 years. He is an example as a human being, leader, educator, researcher and diplomat.”

On July 26 in Japan, Dr. Fu will receive the Watanabe Award from JOSKAS, an organization founded 40 years ago, and its congress president, Dr. Mitsuo Ochi, director of Hiroshima University Hospital and chairman of the Department of Orthopaedic Surgery in the Graduate School of Biomedicine and Health Sciences at Hiroshima University.

Dr. Ochi said the award, named for the father of arthroscopy, is being presented to Dr. Fu because of “his great contributions to ACL reconstruction, and new discoveries and investigations for better ACL reconstruction.”

Pitt/MWRI Researchers Awarded Prestigious Cozzarelli Prize for Top Biomedical Sciences PNAS Paper of 2013

PITTSBURGH, March 7, 2014 – Researchers at the University of Pittsburgh School of Medicine and Magee-Womens Research Institute (MWRI) have been awarded the Cozzarelli Prize in the biomedical sciences for a July 2013 paper published in the Proceedings of the National Academy of Sciences (PNAS) that showed the cells of the placenta may have a unique ability to prevent viruses from crossing from an expectant mother to her growing baby and can transfer that trait to other kinds of cells.

Senior authors Yoel Sadovsky, M.D., Elsie Hilliard Hillman Chair of Women’s Health Research, professor of obstetrics, gynecology and reproductive medicine, Pitt School of Medicine, and MWRI director, and Carolyn Coyne, Ph.D., associate professor, Department of Microbiology and Molecular Genetics at Pitt, and MWRI member, and their research team will be honored on April 27 at a ceremony in Washington, D.C., during the National Academy of Sciences Annual Meeting.

The annual award was established in 2005 and named in 2007 for late PNAS Editor-in-Chief Nicholas R. Cozzarelli and acknowledges papers that reflect scientific excellence and originality. Five other papers in fields including the physical and mathematical sciences; biological sciences; engineering and applied sciences; behavioral and social sciences; and applied biological, agricultural and environmental sciences that were published in PNAS in 2013 also will receive awards.

“To receive the Cozzarelli Prize is a tremendous honor,” Dr.  Sadovsky said. “Our findings revealed elegant and complex mechanisms that have evolved to keep viruses from infecting the placenta, which could help us develop therapies for other kinds of viral infections.”

“We are very proud of our research paper and are gratified that the scientific community deems our work noteworthy,” Dr. Coyne said.

For their paper, which was published on July 16, 2013, the research team studied human trophoblast cells in the lab, exposing them to a panel of viruses. Unlike non-placental cells, trophoblasts were resistant to viral infection, but that trait was not a result of an inability of viruses to bind or enter the cells. When the medium, or fluid environment, in which the trophoblasts were cultured was transferred to non-placental cells, such as those that line blood vessels, they became resistant to viral infection, too.

The team found that when the medium was exposed to sound waves in a process called sonication, viral resistance was no longer transferred to non-placental cells. This finding led them to take a closer look at exosomes, which are tiny spheres called nanovesicles that are secreted by trophoblasts and are sensitive to sonication. Fragments of genetic material called microRNAs contained within the exosomes, as well as lab-synthesized mimics of them, were able to induce autophagy, a mechanism of prolonged cellular recycling and survival. Blocking autophagy at least partially restored the cells’ vulnerability to viral infections.

“We might be able to use these microRNAs to reduce the risk of viral infection in other cells outside of pregnancy, or perhaps to treat diseases where enhancing autophagy would be beneficial,” Dr. Coyne said.

Co-authors include other researchers from MWRI; the University of Pittsburgh departments of Obstetrics, Gynecology and Reproductive Sciences, Microbiology and Molecular Genetics, Infectious Diseases and Microbiology, Cell Biology and Physiology, and Surgery; and the University of Pittsburgh Cancer Institute.

The project was funded by the Pennsylvania Department of Health Research, the National Institutes of Health grants HD065893, HD071707, AI081759 and HD075665 and the Burroughs Wellcome Fund.

$2 Million NIH Grant Renews UPCI Research into Viruses, Cancer Pathways

PITTSBURGH, March 5, 2014 – The National Institutes of Health (NIH) has renewed a grant for more than $2 million for Patrick Moore, M.D., M.P.H., director of the Molecular Virology Program at the University of Pittsburgh Cancer Institute (UPCI), who will use the money to continue research into the newest human cancer virus causing most Merkel cell carcinomas.

A team led by Dr. Moore and Yuan Chang, M.D. discovered the Merkel cell polyomavirus in 2008, the seventh human cancer virus identified and the second discovered by Dr. Moore’s group under the original NIH grant that expires March 31. The new grant will fund the research through March 2019.

“Our initial grant was highly successful and led to new methods to diagnose and treat Merkel cell carcinoma,” Dr. Moore said. “We believe that these findings can help us to uncover new causes of other cancers, which may speed development and testing of new cancer therapies.”

Drs. Moore, Chang and their colleagues at Pitt identified a protein that allows the usually harmless polyomavirus to transform healthy cells into Merkel cell carcinoma, a rare but deadly skin cancer. They hope their work — which emphasizes the importance of fundamental basic science research to medical progress — can soon be translated into human clinical trials.

“Viruses are an important model for cancer research,” said Dr. Chang. “We’ve found that it may be possible to kill cancerous tumors by targeting the pathways these viruses use. That’s significant when you consider that 20 percent of all cancers are related to infectious diseases.”

The NIH grant number is R01 CA136806-06.

High Consumption of Fish Oil May Benefit Cardiovascular Health, Pitt Public Health Finds

PITTSBURGH, March 4, 2014 – Eating fish in amounts comparable to those of people living in Japan seems to impart a protective factor that wards off heart disease, according to an international study funded by the National Institutes of Health (NIH) and led by the University of Pittsburgh Graduate School of Public Health.

Middle-aged Japanese men living in Japan had lower incidence of coronary artery calcification, a predictor of heart disease, than middle-aged white men living in the United States, likely due to the significantly higher consumption of omega-3 fatty acids found in fish. The findings will be published in the March 6 issue of the journal Heart.

“Multiple studies have looked at the effect of fish oil on cardiovascular health, with mixed results,” said lead author Akira Sekikawa, M.D., Ph.D., associate professor of epidemiology at Pitt Public Health. “Previous studies investigated substantially lower intake of omega-3 fatty acids than what people in Japan actually get through their diet. Our study seems to indicate that the level of marine-derived omega-3 fatty acids consumed must be higher than previously thought to impart substantial protection.”

Marine-derived omega-3 fatty acids, which are found in fish, especially oily fish, as well as in squid and krill, may help to reduce inflammation and slow the formation of fatty plaques in arteries.

Researchers at Pitt partnered with scientists in Japan, Hawaii and Philadelphia to follow nearly 300 men for five years, tracking multiple factors that affect cardiovascular health, including cigarette smoking, the level of cholesterol in the blood and alcohol consumption, as well as their rates of diabetes and high blood pressure.

After accounting for risk factors for heart disease, the U.S. men had three times the incidence of coronary artery calcification as the Japanese men. Meanwhile, the levels of marine-derived omega-3 fatty acid in the blood were more than 100 percent higher in the Japanese than in the white men.

“The vast difference in heart disease and levels of marine-derived omega-3 fatty acid are not due to genetic factors,” said Dr. Sekikawa. “When we look at Japanese Americans, we find that their levels of coronary artery calcification are actually higher than that of the rest of the U.S. population.”

The average dietary intake of fish by Japanese people living in Japan is nearly 100 grams each day, which the American Heart Association considers 1 ½ servings. The average American eats about 7 to 13 grams of fish a day, or about one serving a week.

Heart disease is the leading cause of death in the U.S. and globally, according to the World Health Organization. However, Japan bucks this trend, with cancer as the leading cause of death.

“I am not encouraging Americans to start consuming massive amounts of fish, which may have harmful contaminants, such as mercury, in their flesh,” said Dr. Sekikawa. “However, our findings indicate that it is worthwhile to take another look at the effect of marine-derived omega-3 fatty acids on heart disease, particularly when consumed at higher rates than previously investigated.”

Additional co-authors on this study are Sunghee Lee, Ph.D., Rhobert W. Evans, Ph.D., Kim Sutton-Tyrrell, Ph.D., Marnie Bertolet, Ph.D., Emma J.M. Barinas-Mitchell, Ph.D., and Lewis H. Kuller, M.D., Dr.P.H., all of Pitt Public Health; Katsuyuki Miura, M.D., Ph.D., Akira Fujiyoshi, M.D., Ph.D., M.P.H., Takashi Kadowaki, M.D., Ph.D., Sayaka Kadowaki, M.D., Ph.D., Tomonori Okamura, M.D., Ph.D., Aya Kadota, M.D., Ph.D., Hirotsugu Ueshima, M.D., Ph.D., and Hiroshi Maegawa, M.D., Ph.D., all of Shiga University of Medical Science in Japan; Daniel Edmundowicz, M.D., of Temple University; Kamal H. Masaki, M.D., and Bradley J. Wilcox, M.D., both of the University of Hawaii; Yasuyuki Nakamura, M.D., Ph.D., of Kyoto Women’s University; and Todd B. Seto, M.D., of Queen’s Hospital in Hawaii.

This research was supported by NIH grants HL068200, HL071561, UL1RR024153 and UL1TR00005; and Japanese Ministry of Education Culture, Sports, Science and Technology grants B 16790335 and A 13307016, 17209023 and 21249043.

Pitt Public Health Analysis Provides Guidance on Hospital Community Benefit Programs

PITTSBURGH, March 3, 2014 – A new analysis led by the University of Pittsburgh Graduate School of Public Health offers insights for nonprofit hospitals in implementing community health improvement programs.

In a special issue of the Journal of Health Care for the Poor and Underserved that focuses on the Affordable Care Act (ACA), a multidisciplinary team of Pitt researchers explore published research on existing community benefit programs at U.S. hospitals and explain how rigorous implementation of such programs could help hospitals both meet federal requirements and improve the health of the populations they serve.

“Hospitals have long provided uncompensated care to people who could not otherwise afford it, and this in part has justified their nonprofit status. One goal of the ACA is to provide health insurance to more individuals, thereby potentially reducing  uncompensated care,” said lead author Jessica Burke, Ph.D., M.H.S., associate professor of community and behavioral health sciences at Pitt Public Health. “By working with public health professionals, hospitals can design and implement effective community benefit programs, such as preventative care outreach, that will improve the health of people in their service area and ultimately support continued nonprofit status.”

Dr. Burke and her colleagues note that “community health needs assessments,” which are required by the ACA and rely on large surveys and input from community stakeholders, including minorities and underserved populations, can provide information to help guide the development of community benefit programs, as well as provide data needed to assess their impact.

By evaluating 106 scientific articles detailing hospital-based community benefit programs, Dr. Burke and her colleagues were able to categorize the programs into those based in the hospital and those administered at a community facility, finding that the programs were split almost evenly.

Hospital-based programs typically included preventative screenings or health education. Outside the hospitals, the programs included hospital after-care and benefits and coverage counseling, but were largely community-based programs, either with or without a community partner organization, such as a local school or community center.

“More than 80 percent of the community-based programs included a community partner, which can facilitate greater reach into a community,” said Dr. Burke. “The more you can engage the community in the benefit programs you are trying to provide, the greater the likelihood of a positive outcome.”

The analysis reinforces the value hospitals and health systems can derive from partnering with public health professionals to design their community health needs assessments and determine the best community benefit programs to address those needs, said senior author Everette James, J.D., M.B.A., professor of health policy and management in Pitt Public Health and director of Pitt’s Health Policy Institute.

“Public health researchers add methodological rigor and experience with a range of evidence-based interventions to hospital community health implementation strategies,” said Mr. James, who recently served as the 25th Pennsylvania Secretary of Health. “Our study is intended to strengthen this link between hospital programs and population health, and to provide useful information for hospitals and their public health partners as they comply with new ACA requirements.”

UPMC worked with Dr. Burke and her colleagues at Pitt Public Health and Pitt’s Health Policy Institute to conduct community health needs assessments for 13 of its hospitals, which the health system then used to guide its community benefit programs and set community health improvement goals.

Additional authors on this research include Sandra Truong, M.P.H., and Steve Albert, Ph.D., M.P.H., both of Pitt Public Health; Johanna Steenrod, M.S.G.F.A., and Christine Gibert, M.P.H., both of Pitt’s Health Policy Institute; and Barbara Folb, M.M., M.L.S., M.P.H., and Ahlam Saleh, M.L.S., both of Pitt’s Health Sciences Library System.

Funding for this research was provided by Pitt’s Health Policy Institute.

Second Annual Update on the Multidisciplinary Management of Pituitary Tumors

PITTSBURGH, Feb. 27, 2014 – The Second Annual Update on the Multidisciplinary Management of Pituitary Tumors will be held at UPMC Shadyside in Pittsburgh, Pa., on Friday, April 4, 2014.

This conference will cover the most recent advances in the diagnosis and treatment of pituitary tumors, including functioning and nonfunctioning tumors, hypopituitarism, and pituitary adenomas. The role of and advances in surgical and medical therapies for pituitary tumors, and perioperative management of pituitary tumors will also be discussed.

Who Should Attend
This conference is designed for physicians, physicians’ assistants, nurses, and other health care professionals practicing in the areas of Endocrinology and Metabolism, Family Medicine, General Internal Medicine, and Neurosurgery.

Location
UPMC Shadyside, West Wing Auditorium – First Floor, 5230 Centre Avenue, Pittsburgh, PA, 15232

Course Directors
Paul A. Gardner, MD
Associate Professor of Medicine
University of Pittsburgh School of Medicine
Co-Director, Center for Cranial Base Surgery, UPMC

Sue M. Challinor, MD
Associate Professor of Medicine
Division of Endocrinology and Metabolism
University of Pittsburgh School of Medicine

For more information, or to register online, please visit the Center for Continuing Education in the Health Sciences page.

Continuing Medical Education
The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The University of Pittsburgh School of Medicine designates this live activity for a maximum of 6.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded 0.6 continuing education units (CEUs) which are equal to 6.2 contact hours.

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